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Chronic pulmonary embolism

Deng-Wei Chou, Shu-Ling Wu, Kuo-Mou Chung, Shu-Chen Han, Bruno Man-Hon Cheung
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed...
October 1, 2016: Clinics
K Ye, X Lu, W Li, M Yin, X Liu, J Qin, G Liu, M Jiang
OBJECTIVE: To evaluate the technical aspects and short-term clinical results of stent placement for chronic occlusion of a filter-bearing inferior vena cava (IVC) in patients with severe post-thrombotic syndrome (PTS). METHODS: A retrospective analysis of 24 patients with severe PTS associated with occlusion of a filter-bearing IVC treated by stent placement was conducted at a single institution from January 2010 to December 2014. Patient-reported quality of life and limb Villalta scores were evaluated before and after treatment by questionnaire and clinical examination, respectively...
October 14, 2016: European Journal of Vascular and Endovascular Surgery
Manuel Monti, Giovanni Maria Vincentelli, Giuseppe Murdolo, Giuliano Bertazzoni, Francesco Rocco Pugliese, Francesco Borgognoni, Maria Pia Ruggieri, Raffaele Landolfi
INTRODUCTION: Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke and and the most common preventable cause of hospital-related death. Several studies have demonstrated a significant reduction of fatal pulmonary embolism attributed to the introduction of thromboprophylactic measures and changes in hospital practices. However, the influence of some demographical variables, especially age, has largely been under appreciated...
September 2016: Recenti Progressi in Medicina
Nicole K Behnke, Dustin K Baker, Shin Xu, Thomas E Niemeier, Shawna L Watson, Brent A Ponce
PURPOSE: The skeleton is the third most common site of cancer metastases. Approximately 10 % of patients with bone metastases will develop a pathologic fracture, with significant associated morbidity and mortality. The purpose of this study was to identify risk factors for same-admission mortality after pathologic fractures secondary to metastatic cancer. METHODS: The Nationwide Inpatient Sample database was queried from 2002 to 2013 for hospitalized patients with diagnoses of pathologic fracture and a primary cancer at high risk for skeletal metastasis...
October 4, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Marijan Bosevski, Elizabeta Srbinovska-Kostovska
BACKGROUND: Pulmonary embolism and deep venous thrombosis, known as venous thromboembolism (VTE), are associated with a high proportion of morbidity and mortality. AIM: Aim of this review is to emphasise current diagnostic and therapeutic modalities for VTE. RESULTS: No differences have been noticed in European and American guidelines in diagnostic approach of this disorder. Today there is enough clinical information for the use of heparin (either, unfractionated or low molecular) and vitamin K antagonists in the treatment of acute and chronic phases of VTE...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Yasuhiko Kubota, Stephanie J London, Mary Cushman, Alanna M Chamberlain, Wayne D Rosamond, Susan R Heckbert, Neil Zakai, Aaron R Folsom
BACKGROUND: The evidence of the association between chronic obstructive pulmonary disease (COPD) and venous thromboembolism (VTE) is limited. There is no study investigating the association of restrictive lung disease (RLD) and respiratory symptoms with VTE. OBJECTIVES: To investigate prospectively the association of lung function and respiratory symptoms with VTE. PATIENTS/METHODS: In 1987-1989, we assessed lung function using spirometry and obtained information on respiratory symptoms (cough, phlegm and dyspnea) in 14 654 participants aged 45-64, without a history of VTE or anticoagulant use, and followed them through 2,011...
October 1, 2016: Journal of Thrombosis and Haemostasis: JTH
Mustafa Bilgi, Ahmet Keser, Huseyin Katlandur, Emel Sahin, Ali Osman Kalkan, Murat Yildiz, Aysel Kiyici, Mustafa Keles
INTRODUCTION: Ischemia-modified albumin (IMA) is a marker which can be associated with oxidative stress in various ischemic and non-ischemic processes. Oxidative stress plays roles in diabetes mellitus, its complications and pathogenesis. Serum IMA levels are examined in various clinical events. However, urine IMA levels have not yet been evaluated in diabetic patients. In this study, we aim to examine the relationship between metabolic features and urine microalbuminuria levels of diabetic patients and their urine IMA levels...
October 1, 2016: Journal of Clinical Laboratory Analysis
Jianming Guo, Yongquan Gu, Lianrui Guo, Zhu Tong, Xixiang Gao
Massive pulmonary embolism (MPE) is associated with a high rate of mortality, and chronic thromboembolic pulmonary hypertension leads to ongoing morbidity among many survivors. Here we report a case of a MPE successfully treated by Angiojet rheolytic thrombectomy combined with catheter fragmentation. This is the first report of the use of these two methods together for MPE treatment.
September 20, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Etienne-Marie Jutant, Marc Humbert
Pulmonary hypertension (PH) is a cardio-pulmonary disorder that may involve multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases. Its definition is an increase in mean pulmonary artery pressure (mPAP) \hbox{$\geqslant $} ⩾ 25 mmHg at rest, leading to right heart failure and ultimately death. The clinical classification of pulmonary hypertension (PH) categorizes PH into groups which share similar pathophysiological and hemodynamic characteristics and treatments...
2016: Biologie Aujourd'hui
Naofumi Chinen, Yasushi Koyama, Shinji Sato, Yasuo Suzuki
A 34-year-old woman with primary antiphospholipid syndrome was admitted to the Gastroenterology Department of our hospital with fever, acute abdomen, watery diarrhea, and extremely high levels of inflammatory parameters. She had a history of left lower limb deep vein thrombosis and pulmonary embolism and was taking warfarin potassium. Acute gastroenteritis was suspected and an antibiotic was administered, but symptoms progressed. Abdominal ultrasonography showed occlusion of the left hepatic vein and the middle hepatic vein and her D-dimer level was high...
2016: Case Reports in Rheumatology
J Ryan Hill, Braden McKnight, William C Pannell, Nathanael Heckmann, Lakshmanan Sivasundaram, Amir Mostofi, Reza Omid, George F Rick Hatch
PURPOSE: The purpose of this study was to evaluate a large population of shoulder arthroscopy cases in order to provide insight into the risk factors associated with readmission following this common orthopaedic procedure. METHODS: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) billing codes to identify all patients older than 18 years of age who underwent shoulder arthroscopy between 2011 and 2013...
September 15, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert I Handin
The administration of intravenous heparin to postoperative patients by Barritt and Jordan reduced the incidence of fatal and nonfatal pulmonary embolism and established heparin as the standard for parenteral anticoagulation. The coumarin family of vitamin K antagonists quickly became the standard for long-term oral anticoagulation. Aspirin became a widely used antithrombotic agent after the discovery that chronic oral administration reduced the incidence of secondary strokes and myocardial infarction. This article gives a brief history of antithrombotic therapy, including the discovery of heparin, the vitamin k antagonists, and the utility of aspirin...
October 2016: Hematology/oncology Clinics of North America
Elizabeth Hitchner, Brittanie D Baughman, Salil Soman, Becky Long, Allyson Rosen, Wei Zhou
OBJECTIVE: Carotid interventions are important in helping to reduce the risk of stroke for patients with high-grade carotid artery stenosis; however, subclinical cerebral microemboli can occur during these procedures. Associations have been found between the incidence of microemboli and postoperative decline in memory. We therefore sought to determine whether this decline persisted long-term and to assess changes in other cognitive domains. METHODS: Patients were prospectively recruited under an Institutional Review Board-approved protocol at a single academic center...
September 12, 2016: Journal of Vascular Surgery
Eduard Shantsila, Gregory Yh Lip
BACKGROUND: Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure. Oral anticoagulants have become a standard in the management of heart failure with atrial fibrillation...
September 15, 2016: Cochrane Database of Systematic Reviews
Walter Ageno, Alexander G G Turpie
Venous thromboembolism (VTE), comprising both deep-vein thrombosis (DVT) and pulmonary embolism (PE), is a serious and common cardiovascular disease associated with the risk of chronic complications, recurrent VTE events and even death. The treatment landscape has, in recent years, seen a paradigm shift from the use of traditional anticoagulants (low-molecular-weight heparin [LMWH] overlapping with and followed by a vitamin K antagonist [VKA]) to non-VKA oral anticoagulants (NOACs). This class of agents, encompassing direct factor Xa inhibitors and direct thrombin inhibitors have shown non-inferior efficacy and better safety to standard of care in randomised controlled trials (RCTs)...
September 14, 2016: Thrombosis and Haemostasis
Michael R Pinsky
The primary role of the right ventricle (RV) is to deliver all the blood it receives per beat into the pulmonary circulation without causing right atrial pressure to rise. To the extent that it also does not impede left ventricular (LV) filling, cardiac output responsiveness to increased metabolic demand is optimized. Since cardiac output is a function of metabolic demand of the body, during stress and exercise states the flow to the RV can vary widely. Also, instantaneous venous return varies widely for a constant cardiac output as ventilatory efforts alter the dynamic pressure gradient for venous return...
September 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Jun-Jun Yeh, Yu-Chiao Wang, Chia-Hung Kao
PURPOSE: We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE). METHODS: From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876)...
2016: PloS One
Walter Serra, Ernesto Crisafulli, Nicola Sverzellati, P Tito Ugolotti, Panajota Tzani, Emilio Marangio, Diego Ardissino, Tiziano Gherli, Alfredo Chetta
BACKGROUND: Pulmonary hypertension (PH) is frequently found at the time of diagnosis of pulmonary embolism (PE). An incomplete resolution of PE can lead to chronic thromboembolic pulmonary hypertension (CTPH). Transthoracic echocardiogram (TTE) is the first step to diagnose an abnormality of the pulmonary vasculature. Based on computed tomography (CT), the Qanadli vascular obstruction index has been extensively used to assess acute PE. OBJECTIVES: Our aim was to ascertain whether at the time of diagnosis of an acute PE episode TTE variables and a Qanadli CT index score may be associated with CTPH 2 years later...
2016: Respiration; International Review of Thoracic Diseases
Anair Beverly, Ethan Y Brovman, Raymond J Malapero, Robert W Lekowski, Richard D Urman
OBJECTIVES: To determine the incidence, timing, risk factors for, and outcomes after unplanned reintubation following cardiac surgery in adults. DESIGN: Retrospective analysis of admission data from the American College of Surgeons National Surgical Quality Improvement Project Database, 2007-2013, inclusive. Univariate and multivariate analyses of risk factors and outcomes. PARTICIPANTS: A total of 18,571 patients, over 18 years of age, undergoing cardiac surgery...
May 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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